Members of the Health IT Policy Committee, a government advisory body, recently debated whether Stage 2 of meaningful use should require the use of web portals to provide patients with online summaries of hospital visits. Most of the participants leaned against doing so for technical and security reasons. But, because of certain Stage 1 criteria, the whole discussion might become moot by 2013, when the second-stage requirements are due to go into effect.
On the ambulatory-care side, more and more physicians are purchasing patient portals linked to their EHRs in order to meet two current measures of meaningful use: providing visit summaries to at least half of their patients and giving electronic copies of health information to 50 percent of patients upon request.
According to consultants and vendors, the Continuity of Care Document (CCD) that the leading EHRs generate can meet both criteria, and can be automatically sent to a patient portal after each patient visit. Alternatively, a practice could store the CCD on a thumb drive or a CD and give that to the patient. But it's much easier to meet the criteria with a portal--and the portal offers many other advantages for both operational efficiency and the quality of care, physicians say.
Among the benefits are the ability of patients to do the following online: request refills; make appointments; view lab results; receive reminders about needed preventive and chronic care; ask their doctor a question; fill out a medical history or a family and social history; view statements; and pay bills. Most of these portal features also reduce work and cost for practices. For example, when patients request refills or appointments online, practices receive fewer phone calls.
A recent KLAS survey found that more than two-thirds of providers who had an EHR were not sharing records electronically with patients. That, plus reports from vendors, suggests that only a quarter of these physicians are using portals today. But, as EHR vendors offer more robust portals, and even bundle them into their standard package--as eClinicalWorks recently did--the use of portals is bound to increase. And vendors say that meaningful use is already raising the demand for portals among their customers.
As this trend grows in the ambulatory-care sphere, hospitals will have to follow suit. Already, they have minimal record-sharing requirements in Stage 1; if patients begin to expect access to their records via portals, hospitals won't be able to stop the tide. So the debate over the place of portals in Stage 2 is really a rear-guard action, possibly sparked by provider resistance to other proposed Stage 2 criteria.
While reasonable people can disagree about the technical details and the adequacy of security safeguards, the time has come for healthcare providers to make it easy for patients to view their own medical records. And by using the portal technology, providers can also increase patient self-service, as well as their own operational efficiency. - Ken